For one Minnesota family, a burial, then a birth amid COVID-19 pandemic

Even as things were getting really bad, Cassie Bonstrom's mom would text her not to worry. This is the natural order, she told her. People live and then they die. Babies are born. If she was going to worry about anything, it should be the baby.

At almost nine months pregnant, that's all Bonstrom imagined she would be worrying about. But nothing about the new world was typical.

Her mom, Susan Jack, had contracted COVID-19, the disease caused by the corona­virus. Jack, 69, who lived in suburban Bloomington, had already been to the brink of death once before and came back. But there was something more sinister about this virus, which by then had already killed tens of thousands of people in places far away from Bloomington.

At home, the news said the number of positive cases was growing and spreading to every corner of the state. The first reported deaths were coming in, but officials warned that the worst was yet to come. "As COVID started being talked about, she just knew it," Bonstrom said. "She said, 'You know, I'm a sitting duck for this. It's not going to go well if I get it.' "

The natural order of things was threatening to take over, but Bonstrom thought, if her mom could just hang on long enough to see the baby, things might be OK. After all, the whole ordeal started with concern about the baby.

In early March, Bonstrom got a cough. She didn't have a fever, but news of the pandemic was starting to take hold, and she was worried about getting the right prenatal care. It was early enough that her pregnancy and symptoms made her a good candidate to be tested for COVID-19, so she made arrangements with her doctor to visit a drive-through testing site.

But as the grip of the virus quickly tightened, so suddenly did Minnesota health officials' rules on who could be tested: only health care workers, those in long-term care facilities and people in the hospital.

Without a test, uncertainty hung over her pregnancy for weeks, even as Jack's wife, Kim Kammeier, a nurse for more than 30 years, got sick and went in for a COVID-19 test. As she waited for results, in the back of her mind, Bonstrom was thinking about her mom's "sitting duck" comment. Jack, a retired marriage and family therapist, was diagnosed with idiopathic pulmonary fibrosis five years earlier.

"She wasn't a smoker, it wasn't cancer, it wasn't due to anything," Bonstrom said. "It was all of a sudden her lungs just started scarring over and not being able to breathe."

Things took a sharp turn in 2018 and Jack was on the verge of death when doctors found a match for a double lung transplant. At that time, they warned she could be trading one chronic condition for another, but she knew the risks and forged ahead. After the surgery, she was in and out of the hospital for over a year, and this March, another whammy: She had colon cancer.

The doctor told her not to worry, she would make it to see Bonstrom's baby born in April, which was all she could talk about.

Jack had two daughters with her ex-husband, and her daughters each grew up to have two daughters of their own. Bonstrom's baby — another girl — would be the newest member of what Jack called her "gaggle of girls."

Jack had an appointment to get the cancer removed on March 23, but days earlier she started having trouble breathing. That's not uncommon for someone with a lung transplant, but this was worse, and it escalated quickly. As the days passed, Jack was in and out of consciousness and resisting going to the hospital. Jack knew if she tested positive for COVID-19 at the hospital, she'd have to stay there alone.

Eventually, though, she decided that's what she would do. Bonstrom and her sister drove behind her mom and stepmom to the hospital and watched as a team of healthcare workers covered in personal protective equipment came out and put Jack on a stretcher and took her inside.

"I'm just doing this for the baby," Jack told her wife before she went inside, Bonstrom remembered. "I just want to be here long enough to see the baby."

It was the last time any of them saw her alive.

Jack was given a rapid COVID-19 test when she was admitted to the hospital, which came back positive.

Kammeier got her test results back shortly after that: She also had the illness, but her symptoms weren't as severe For the family, the following days were a blur of calls and texts with Jack and her caregivers. She was put in the ICU, but then taken out, which the family thought was a good sign.

Late on March 30, Jack complained about belly pain, and caregivers realized she had massive bleeding in her stomach. Her condition deteriorated rapidly after that, and she had to be intubated.

On March 31, she died in the hospital. Bonstrom's Caesarean section was scheduled for the following weekend. "She just missed it," Bonstrom said. "By days."

They wanted closure before the baby was born, so they held a ritual burial at Lakewood Cemetery in Minneapolis with only a small group of people, a requirement for funerals under the stay-at-home order issued by the governor. The gaggle of girls was not fully represented.

Within hours, Bonstrom was rushing across town. She saw a Facebook post about a new lab in Edina that was conducting antibody testing that could tell if a person already had COVID-19 and was immune.

It's not an official COVID-19 test, and health officials have warned that a negative result does not rule out an infection. But with her baby coming in days, she wanted any information that would help her deliver safely.

More than a month after she felt sick, and hours after burying her mom, she got her finger pricked, waited 10 minutes and got her results. Negative. She wasn't immune, but as far as they could tell she hadn't gotten the virus either.

Bonstrom's not very religious, and neither was her mom, but with her baby due on Easter weekend, she kept hearing about the resurrection. Death and new beginnings, so close together, and the pain and joy that comes along with it.

Her daughter was born Saturday without complications. Given the family's exposure to COVID-19, only Bonstrom's husband, Joel, was allowed to be in the hospital.

It was strange not having any other family waiting in the lobby, she said, especially her mom.

But Susan Jack is with the newest member of the gaggle in name: Harley Sue Kathleen Bonstrom.